Individual
RYAN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
20 PROSPECT AVE STE 404, HACKENSACK, NJ 07601-1941
(551) 996-4371
Mailing address
20 PROSPECT AVE STE 404, HACKENSACK, NJ 07601-1941
(551) 996-4371
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
25MA10834500
NJ
208C00000X
Colon & Rectal Surgery Physician
Primary
25MA10834500
NJ
Other
Enumeration date
05/22/2014
Last updated
02/10/2022
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